Karachi: Pakistan’s powerful Special Investment Facilitation Council (SIFC) has asked the Sindh government to amend its landmark breastfeeding law to accommodate demands from the Baby Food and Nutrition Council (BFNC)—a powerful lobby of multinational formula milk manufacturers—raising alarm among public health experts and child nutrition advocates.
A formal letter sent by SIFC to the Sindh Health Secretary urges changes in the Sindh Protection and Promotion of Breast-Feeding and Young Child Nutrition Act, 2023, including narrowing the age limit of regulated products from 36 months to 12 months, excluding complementary food from its scope, and allowing retail sale of infant formula outside pharmacies. BFNC has also sought permission for companies to share “scientific information” with healthcare professionals—a move critics say would pave the way for indirect marketing of formula products.
“These changes will effectively gut the law,” warned a senior official at the Sindh Health Department. “The pressure is immense, and it’s clearly coming at the behest of commercial interests under the guise of ‘ease of doing business’.”
The Sindh breastfeeding law, enacted in 2023, is widely regarded as a progressive step to protect infant health by encouraging exclusive breastfeeding for six months and continued breastfeeding up to 36 months with nutritious complementary feeding.
It also seeks to regulate and restrict unethical promotion of formula milk products, which health professionals argue are often aggressively marketed to new mothers despite well-documented risks.
BFNC, a conglomerate of infant formula producers operating in Pakistan, has already succeeded in reclassifying infant formula as “food” instead of a pharmaceutical product—placing it under the oversight of under-resourced provincial food authorities instead of the Drug Regulatory Authority of Pakistan (DRAP). Experts say the current push to weaken Sindh’s legislation is part of a broader strategy to neutralize regulation altogether.
“Except for a few hundred very sick infants, no child in Pakistan needs formula milk,” said Prof. Jamal Raza, a senior pediatrician and Executive Director of Sindh Institute of Child Health and Neonatology (SICHN) who helped draft the law. “It’s a profit-driven industry exploiting families, and it’s draining our foreign reserves.”
Pakistan imports formula milk worth millions of dollars every year. UNICEF estimates that only 48% of infants in the country are exclusively breastfed in the first six months—far below global health targets.
This poor breastfeeding rate contributes significantly to Pakistan’s high infant mortality rate, which stands at 54 per 1,000 live births. Breastfeeding is proven to reduce the risk of diarrhoea, pneumonia, and malnutrition—leading causes of infant deaths in the country.
Nutrition International’s “Cost of Not Breastfeeding” tool calculates that Pakistan loses approximately USD 2.8 billion annually due to suboptimal breastfeeding practices—losses arising from higher healthcare costs, reduced cognitive development, and long-term productivity setbacks. In addition, US 888 million are spent on breastmilk substitutes.
While Sindh is the only province to have passed a breastfeeding protection law, efforts to enact similar legislation at the federal level have failed. A bill introduced in the National Assembly by a pediatrician-turned-senator has been stalled for years, largely due to industry lobbying.
“Instead of replicating this law across the country, we are now watching attempts to dismantle it,” said a public health researcher in Karachi. “It’s not just shortsighted, it’s dangerous.”
National and international child health advocates including Pakistan Pediatric Association (PPA), Unicef and Nutrition International have warned that any dilution of the Sindh Act will embolden corporate lobbying and weaken Pakistan’s commitment to the International Code of Marketing of Breastmilk Substitutes.
In contrast, the Sindh law had been held up as a model by nutrition stakeholders around the world for its strong protections against commercial interference.
Now, with pressure mounting from SIFC and the BFNC, officials within the Sindh government say they are being pushed to revise a law that took years of advocacy and drafting, and overcame strong resistance from formula milk lobbies.
“This is not just legislation—it’s a life-saving measure,” said a senior health official. “If we surrender to commercial interests, we endanger the lives and futures of our children. It’s as simple as that.”
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